Saturday, September 13, 2014

Down with Couch-to-5K!'s Couch-to-5K Program, I'm sure, has helped many, many people begin running and train for their first 5K.  It's been helping me go back from lazy, post-surgeried couch pototato to elite (ha!) marathoner in just a few short weeks.

Again, just kidding.  I've been doing the Couch-to-5K program since July 19, which is 8 weeks.  There were a few "weeks" of the program that I repeated because I felt like I was still struggling to complete them, and then held myself back again over the last two weeks because been sick with some bad summer cold or upper respiratory infection.  Basically, I've been stuck at "week 4" for about 3 weeks now.

And here's the thing -- I think, if I follow the plan, I always would be.  From weeks 1-3, I think the Couch-to-5K progresses pretty reasonably.  I felt like I needed a repeat of week 3, but then bumped myself up to week 4 and was able to complete several times with mixed success (again, allergies and respiratory illness make for bad training partners).  The jump to week 4, where you are running 5 minutes at a time and your walk breaks are NOTICEABLY shorter, is a big one, but I don't think unreasonable.

But there's the thing:  Week 5 is a bitch.

So let me get this straight, Couch-to-5K.  The longest you've had me run is 5 minutes, and one week later, I'm supposed to run TWO MILES?    The progression to those first two workouts of week 5 seems reasonable, but going from running 8 minutes twice with a 5-minute walk in the middle to running for 20 minutes?  It seems like there needs to be another week or two of transition in there.

 Oddly, it seems like once cross this gulf, the plan proceeds pretty reasonably once again, and it seems like the plan is transitioning the trainee from a program of 3 equal workouts per week to two run/walk workouts and then a "long run", which is how must runners train for longer races.  So, in breaking this down and criticizing it, I do think I see the logic behind it.

At any rate, I feel like I could do week 4 over and over and not really be ready for week 5.  It just doesn't seem like, without doing a lot of other cardio (and maybe that's the point, that I should be!) this this is big leap forward to be expected of new runners. 

So, this is where I get off, Couch-to-5K.  I'm back on the "Run half a mile, walk for a minute, run half a mile" plan that Chris and I have used on the 5Ks I've run w/her the past year and a half.  I used this back in January to try to train myself back up, hoping that I'd successfully physical therapy'd myself through injury. I've done this twice now this week, and there was noticeable improvement the second time, but I suspect it had more to do with the weather being 20 degrees cooler than any actual improvement in fitness on my part from Wednesday evening to Saturday morning.

Basically, what happens is I'll do this as-is for a week or two, then hopefully be able to get through the first mile with no walk breaks, but probably still need them on the second mile.  Then, hopefully, the next week or two I'd need the walk break at the end of the first mile, but then be able to get the second mile without walking.  When I can run 2 miles with no walk breaks, I add some back in and try for 3, and after a few weeks of this, I can hopefully run a 5K again.

So yeah, kind of like the Couch-to-5K.

Monday, August 25, 2014

Two Steps Forward, Three Steps Back

I don't mean to be bury the lead.  I hate when the Orioles text messages that I get from the Mid-Atlantic Sports Network read "Jones hits two hits in 7-2 loss to cubs", but here I am doing the same thing.

After a great long weekend in Atlantic City, where I finished my first post-surgery 5K and just had probably the most fun weekend of the year, I'm going to write about how frustrated I am with myself and with the Couch to 5K program.  The "Chickie's & Pete's Boardwalk 5K" and the fun weekend in AC deserve their own blog post. I don't have time to write it and it deserves to be written when I'm feeling more positive.

Until Tuesday of last week (8/19), it seemed like everything was going well in the Couch to 5K program.  I'd repeated week 3, which is:

Brisk five-minute warmup walk, then do two repetitions of the following:
  • Jog 200 yards (or 90 seconds)
  • Walk 200 yards (or 90 seconds)
  • Jog 400 yards (or 3 minutes)
  • Walk 400 yards (or three minutes)
But toward the end of the second week I was stretching the three minute runs into 5-minute runs and everything was going well.  

So, week 4:

Brisk five-minute warmup walk, then:
  • Jog 1/4 mile (or 3 minutes)
  • Walk 1/8 mile (or 90 seconds)
  • Jog 1/2 mile (or 5 minutes)
  • Walk 1/4 mile (or 2-1/2 minutes)
  • Jog 1/4 mile (or 3 minutes)
  • Walk 1/8 mile (or 90 seconds)
  • Jog 1/2 mile (or 5 minutes)
 I did one perfect version of this, on Sunday 8/17, with an extra 3-minute run tacked on the end to bring me back to my car.  I tried again on Tuesday, and was able to complete it, but just felt bad during the run and my legs felt awful for several days after. 

I rested the rest of the week, knowing that the 5K was coming on Saturday.

On Saturday, I completed the 5K, running half a mile walking a minute, repeat.  Legs were sore, but normal, good soreness.  My normal, pre-injury 5K time was around  27 minutes.  We finished the 5K in 45.

Today, I tried to do the same run/walk intervals as the 5K (intending only 2 miles, since I'm trying to train at my roughly my pre-injury training pace, which is closer to a 10:00/mile) and within the first 1/3 of a mile, I was wheezing as if I'd never run before in my life.  My legs felt fine, I just couldn't breathe.

I'm hoping it's just because I forgot my allergy medicine last night and because I tried to run this at the VERY hilly park near our house (I was wheezing way before I hit the big hills, though.)

Meanwhile, though, I think it's back to "Week 3" for a pretty frustrated me.  By the end of "Week 5", I'm supposed to be able to run 2 miles with no walk breaks.  Even before the bad runs last Tuesday and today, I feel like I'm more than a week away from being able to do that.

Saturday, August 16, 2014

The Road is Calling; Today is the Day

It's the middle of August and the temperature was in the low 50s for my run this morning.  Beautiful.  What is not as nice is the last two weeks of running.  Week Three of C25K gets quite a bit harder:  walk 5 minutes, run 90 seconds, walk 90 seconds, run 3 minutes, walk 3 minutes, run 90 seconds, walk 90 seconds, run 3 minutes.

Three minutes is a big step up from 90 seconds and I repeated this week twice.  The second week of it was a struggle: Tuesday my sister alternated 3 minutes walking with 3 minutes running for about 30 minutes; Thursday I kept to plan, but my lungs felt so bad; and today I kicked butt --- substituting 5 minute runs for the three minute runs and feeling pretty well.

I forgot how tough and frustrating running could be, especially when starting out, but this is still just the start of a new story...

Saturday, August 2, 2014

Bilateral Compartment Syndrome Surgery and Recovery

As I've run less and less over the past few years, these blog posts have become less frequent.  But in those few blog posts there's a lot of space given to complaining about (mostly) complaining about and trying to recover from compartment syndrome.  After two years of trying avoid surgery, I finally decided to go under the knife.  I described the lead-up to surgery a few months ago.  Now that I'm (hopefully!) well on the road to recovery, although not nearly as far back on the road to racing again, I figured I'd take the rare opportunity to write a blog post that might actually be informative.

To very briefly recap, I started having symptoms in December 2011. I'd have selling and discomfort in my ankles and calves, more pronounced in the left one, and a noticeable loss of range of motion.  Shinsplints were the initial diagnosis, with compartment syndrome being the next "option" when my problems didn't really respond to the main treatment of shinsplits (rest).  Any time I took a few months off from running, I'd come back and my symptoms would be better, only to come back every time I got back into some consistency of running.  That's why I won't know if this surgery worked for a few more months.

At any rate, a compartment pressure test confirmed the diagnosis in Spring 2013, and I tried a long program of PT to avoid surgery.  No luck.  I had surgery on May 15, 2014.

As I said in that initial post-surgery blog post, I woke up in a fog of post-anesthesia and painkillers, definitely in pain, but not as bad as I feared.

(a few hours post-surgery)

Despite that, those first few days were bad.  I frequently felt nauseous from the vicodin, and when I moved my legs, I would feel a tearing sensation in my legs in the area of the surgery.  If I touched those areas, they would feel hot to the touch, although I think that burning sensation was in my legs, and not actually heat that I was feeling, since my legs were pretty heavily bandaged at this point.  I limped around the house on crutches.  I expected to sleep like a rock that first night, but got very little sleep, and because of that I probably crutched my way around the house too much.  I had big ice packs that I'd wear over my legs (or wrap around them with velcro as I got a little more able to sleep in different positions) for long stretches of time for the next several weeks.

Still, just two days after my surgery, I was at least out of the house for a quick Dunkin Donuts trip.  It probably wasn't worth the discomfort I was in going up and down the stairs or how long it took me to get from the car to Dunkin, but I'd wanted very badly to get out of the house, and my Dr. had said it would be ok to try things like this as long as I was careful.

I'd love to say I got better every day, but there were good days and bad days over the next few weeks.  I felt "pretty good" a week after surgery when I went for my post-surgery consult.  The doctor said everything looked good and that the procedure had gone well, and that I could start to s l o w l y ween myself from the crutches...which would go more slowly than I'd hoped. I was to start out by trying to get around the house without them, but using them when I went outside. 

(Looking great 7 days post-surgery)

I had my surgery on a Thursday, and went back to work the following Wednesday.  It's important to note that I work from home.  If I didn't, I probably would have wanted the whole next week, and it was probably another two weeks before I could really sit at my desk in my upstairs office comfortably.  My legs were most comfortable stretched out in front of me, and there wasn't really a comfortable way to do that at my desk. I could work downstairs on the couch, but I wanted to be up in my office as much as possible so that I could receive calls on my work phone line.  People at work have my cel number, but if that got established, even for a short time, as my "main" number, I thought that would be very hard to put back  in the bag.  

I also had a massive gout the Thursday after surgery.  My gout flares up, usually in one of my big toes, a few times each year, but it seemed especially bad in the weeks after my surgery.  If I didn't drink a ton of water (and even sometimes if I did), I'd have gout flare-ups the next day.  My orthopedist would later say that for gout suffers, it's not uncommon for them to be more susceptible to flare-ups after surgery. And I was stupid -- I think it was because the day of my surgery through Tuesday, I'd drank massive amounts of water -- oceans of water -- every day.  But once I went back to work, I wasn't drinking as much...since I couldn't carry cups of water up to my office with my crutches.  Sports bottles were the easy remedy for this. 

The second weekend after surgery was Memorial Day weekend, and I pushed myself too hard. Chris and I went to an outdoor music and wine event at a local winery with some friends, and I walked around more than I should have -- and tried to be more independent than I should have been.  My attitude was getting pretty bad at this point.  I didn't want to be dropped off closer to where we were sitting.  I didn't want to not be allowed to carry anything while Chris made multiple trips.  The next day, we went out to eat in downtown York, and walked 2 blocks from the parking garage.  These adventures definitely set me back a little, and I was tired and sore over the next few days, and on crutches more often than not, even around the house.

I'd taken vicodin -- one in the morning and one at night -- on Thursday, Friday, and Saturday, and then generally stopped.  I didn't want to continue it longer than I had to because it's addictive, and because I stopped it so quickly, I'm not sure that I'd say it helped a lot.  I did take them the day of my gout flare-up and then for a few days following the Memorial Day adventures.  I took one vicodin twice a day, half the prescribed dose, at my Dr.'s suggestion, since the anesthesia had knocked me out so easily.  Like I said, it's hard to tell if one vicodin at a time really helped.  I took two the day of my gout flare-up, when I was just in agony, and two vicodin definitely made a difference.  Not entirely good, though, I felt VERY spaced out and nauseous.

(My right leg on May 28.  My right leg had the worse swelling of the two, 
and looked worse here than it did a week after surgery.)

Once the calendar turned to June, I turned the corner.  I was walking mostly with crutches, driving short distances again, and feeling much better.  My ankles were still very swollen, but I was making steady progress forward.  At my second post-op appointment on June 11, my doctor said it would be ok to start light exercise with no resistance (Chris and I started going for walks), but I was still about a month away from running.  I went way for a long weekend with college friends, walked a ton and drove all around Philly and Atlantic City, and needed my ice packs, but was ok. 

At my third and final post-op, on July 16, my Dr. told me I had no restrictions, and that I could start running again.  

So where am I today?  So far, my legs feel mostly fine.  My left leg -- which was the worse-afflicted with compartment syndrome -- is better than the right leg.  On my right leg, I've got some numb spots (which are a known risk of the surgery, they might never heal) and a little bit of swelling around the ankle.  I have 3 incisions on each leg, and the ones on the outside of my ankles are the ones that bother me most, because they continue to be persistently itchy as they continue to heal.

Did I make the right choice?  Here, 2.5 months later, I'm confident that I did.  If I keep running, and my symptoms return, then there was another contributing factor and it's back to the drawing board and probably off the racing circuit, but I'll worry about that in a few months.  

Right now, it's time to run.

Saturday, July 26, 2014

Running Week 1, 2.0

I've finished the first week of the Couch-to-5K program.  I know, everyone line up for the parade.  But I have to blog about something, right?  (I do owe any readers that I might still have a longer post about the recovery from the surgery, since this is my rare chance to actually be informative.)

As proscribed by venerable C25K, I ran 3x last week:  5 minute warm-up walk followed by 15 minutes of alternating one-minute of running with 90 seconds of walking. It went as well as could be expected.  I did my run/walks last Saturday, Tuesday, and Thursday.  My legs felt good, but I can tell I'm clearly out of shape, as I really had to catch my breath on the walk breaks.

This morning, I did the first workout of week 2: 5 minute warm-up walk, followed by alternating 90 seconds of running with two minutes walking for 15 minutes.  Both the running and the walking portions seemed interminably long after week 1.

It's way to early to draw any conclusions about my surgery.  I had compartment syndrome.  The pressure test quantitatively showed it.  What we can't say for sure if it was the sole cause of the problems I was having.  I won't be able to tell if I'm "better" until I'm in shape to pretty consistently run at least 2-3 miles a couple times a week.  If I get to that point and after a few weeks of it my symptoms aren't present, then I'm all better.  If they do, it's back to the drawing board. 

However, I think what's going to happen is that I'll wish I'd just have bitten the bullet and had the surgery a year ago.

Saturday, July 19, 2014

Out of the Ashes, I Rise

Two months and a few days ago, I had my bilateral compartment release surgery. 

Today, I ran.  It felt great.  It was the first run of the first week of's Couch-to-5K Program: 5-mimute walk then alternating 60 seconds of running with 90 seconds of walking for 15 more minutes. 

I felt awesome during the run portions and then very much had to catch my breath during the walks.

It was glorious.

Saturday, May 17, 2014

Under the Knife

Since the end of 2011, I've been struggling off and on -- more on -- with seems to be exertional compartment syndrome.  I was diagnosed with shinsplints in January, came back after a month rest, faster than ever, and then symptoms -- pain in the ankle and shin, loss of range of motion in the left foot -- became persistent again in the fall.  I rested again, started running again in early 2013, but was seldom pain-free, and the the rather-intrusive compartment pressure test showed that I did indeed have compartment syndrome in both legs. 

I really didn't want to have surgery, even though my orthopedist said that it was the most reliable cure for compartment syndrome, so I tried physical therapy. His opinion was that it was worth trying, but he was pessimistic that it would work. It seemed like it worked when I got serious about running again in January...until it didn't, and symptoms returned.  I made the decision to have the surgery.  I met one more time with my orthopedist, who agreed, naturally, that if I wanted to train for longer races again, that surgery was the best course of action for me.

I met with the surgeon in early April, and he explained that the procedure involves making incisions in the layer of fascia around the muscles in my lower leg compartments, which releases the pressure and should relieve symptoms.  He said that was a relatively simple procedure, and that I could have both legs operated on at the same time, which would make my recovery harder, or I could do one after the other, which would make recovery easier because I would have one "good" leg, but would take twice as long to get both legs "fixed".  I opted to have compartment release surgery on both legs, and I was scheduled to arrive at Wellspan Surgery & Rehabilitation Hospital on Thursday at 7:30am for the outpatient procedure.

I arrived, checked in, and was quickly taken back to remove my clothes (even my underpants) and change into a stylish surgical gown, and then put into a bed in a pre-op room to get ready.

As it turned out, my surgery almost didn't happen, because of this little guy:

This is Domo, aka, "The Fun Panther", our crazy little friend, who left an approximately one-inch long scratch ankle-level on my right shin when he jumped over my lap (I had my right leg crossed over the other).  When I was taken back for pre-op, the nurses quickly said that this little cut might cause my surgery to be delayed.  Cats have a lot of bacteria on their claws, and so they are extra careful with cat scratches because of the risk of infection.  After my surgeon looked at it, and said that it was ok to proceed because it was not near enough any of the incision areas, they shaved my legs and gave me an intraveneous anti-biotic and painkiller.  The anesthesiologist briefly visited and explained his role in the procedure, and then it was go time.

My bed was wheeled back to the operating room, and I slid myself over from the bed to the operating table, unintentionally giving some of the surgical staff a free show.  One of the surgical staff said that they would be giving me the anesthesia, and I would be asleep in about 60 seconds.  I don't think it even took that long...

...and the next thing I recall, I was in my bed with some nurses around me, my legs bandaged and painful, and my head feeling very groggy.  The nurses told me that I told the nurses I was going to make out with my wife and I asked them to bring me my kitty, neither of which happened, of course.

Apparently I made more incoherent conversation with the nurses and then Chris, who had talked with my surgeon while I was still asleep, was brought back so I could talk nonsense with her, too.   I don't really remember much of the conversation, but at some point I was moved from my bed into a recliner, and given my crutches for a brief practice with them, before being wheeled out of the hospital to Chris' car.  When we got home, I groggily made it up the stairs and plopped myself on the couch, where I've spent most of the past three days.

(My legs right after getting home.)

I was definitely in pain, intense at times, but I wouldn't call it excruciating.  I've got a prescription for vicodin, which makes my legs feel better but has made me nauseous at times.  Each of my three days since surgery I've less sharp pains in my legs but more muscle aches and pains.  I didn't sleep much at all on Thursday night, but slept very well last night, and somewhat successfully made my first post-surgery visit outside the house, when Chris took me to Dunkin' Donuts this morning.

I'll learn more about my rehabilitation next Friday, when I go for my post-op visit with my surgeon, and until then at least I'll be on crutches and quite useless.  I was told not to count on driving for four weeks, but that most people are back driving and feeling pretty well in 10 days to two weeks.

And my friend, Domo, who almost prevented my surgery?

He's been a nice little rehab friend.

For further reading about exertional compartment syndrome, here are two other patients' blogs that I've found to be very helpful:

Legs on Fire:  My Experience with Compartment Syndrome

Life After Compartment Syndrome